To what extent are the views and experiences around disordered eating pathology or behaviours considered in the current qualitative research around obesity prevention in the United Kingdom?

Abstract

Background: Eating disorders affect a large portion of the population of globally and within the United Kingdom, and so must be considered as a public health problem. While the topic of obesity is well explored from a public health perspective, eating disorders historically have not been. Literature suggests there may be a link between models of obesity and disordered eating behaviour, particularly Binge Eating Disorder. There has also been recent media attention around the introduction of obesity prevention legislation to make calorie labelling on food menu’s mandatory, particularly how this will affect the eating disorder community. The purpose of this systematic review was to examine the extent to which eating disorders are considered within obesity prevention research. The study aimed to synthesize the current research on obesity prevention, under the lens of whether any considerations toward the eating disorder community have been made in study designs and discussion, to identifying gaps in the literature and the absence of nuance in obesity prevention considering the complex relationship between obesity and eating disorders.

Methods: A PICO (Population, Intervention, Control, Outcomes) framework was used to refine key search terms by population, phenomenon of interest and context. Following this, searches were conducted across five databases to produce a list of articles which were then screened by title/abstract for relevance to search terms. The subsequent list was screened by full text for relevancy to the review question. A critical appraisal skills programme qualitative checklist was used to assess the quality of papers included in the final review. The final papers were then coded inductively to produce categories. Categories were then reviewed to create overarching themes, the relationship between categories and themes was then examined to produce the key findings of the results.

Results: Only one direct reference to eating disorders was identified from the data analysed. Four overarching themes were identified: holistic approaches to weight management, obesity stigma, responsibility and rationale for interventions.

Conclusion: There are significant gaps in the literature examining the relationship between eating disorders and obesity. Further research is required to examine the role of obesity-stigma as a barrier to accessing weight management services and the extent to which it exists amongst healthcare professionals.